National committee formed to develop network policies for hand, face transplantation

Published on: Wednesday, September 17, 2014

Richmond, Va. - Eighteen people who have clinical, professional and personal experience with vascular composite allografts (VCA) have been named to a new committee of the Organ Procurement and Transplantation Network (OPTN) to develop nationwide standards and policies for these procedures. Members of the committee have collectively participated in the majority of VCA transplants that have been performed in the United States.

VCA involves transplantation of multiple structures such as bone, muscle, blood vessels, ligaments, nerves and skin. While face and hand transplantation are currently the most widely known VCA procedures, other types of VCA transplantation may be developed in the future. In July 2013, the U.S. Department of Health and Human Services announced that VCAs will be added to the definition of transplantable organs covered by federal regulation and legislation effective July 3, 2014.

"The demand for VCA transplants and the potential for future forms of these transplants, is growing rapidly," said Kenneth Andreoni, M.D., OPTN/UNOS President. "It is important to establish consistent, national standards at this point to ensure that all patients are considered fairly and that we maintain the best possible outcomes for recipients."

The OPTN/UNOS Vascularized Composite Allograft Transplantation Committee will determine which organ combinations will be covered in policy and develop national standards and processes for VCA donor consent and recovery, as well as a system to prioritize VCA transplant candidates for available organs. Other tasks will include developing a national set of clinical data to be collected on VCA transplants and establishing institutional standards for hospitals that perform VCA transplants. The committee will present its recommendations to the OPTN/UNOS Board of Directors for final action.

Committee members represent a broad variety of disciplines and experience relating to VCA transplantation, including transplant surgery and medicine, plastic and reconstructive surgery, microvascular surgery, orthopedic surgery, immunology, organ recovery, transplant coordination, bioethics and the recipient experience. Individual members are as follows:

Sue V. McDiarmid, M.D., the committee's chair, is medical director of the hand transplantation program at UCLA Medical Center. She is a former OPTN/UNOS president and is current treasurer of the American Society for Reconstructive Transplantation (ASRT).

L. Scott Levin, M.D., FACS, co-vice chair, is director of the hand transplant program at the Hospital of the University of Pennsylvania. He is a founding member and immediate past president of the ASRT.

Richard S. Luskin, M.P.A., co-vice chair, is president and chief executive officer of New England Organ Bank. He has served on the OPTN/UNOS Board of Directors.

Charles E. Alexander, RN, M.S.N., M.B.A., is chief executive officer of The Living Legacy Foundation of Maryland. He is a former OPTN/UNOS president.

Gerald Brandacher, M.D., is scientific director of the reconstructive transplantation program at Johns Hopkins University School of Medicine. He is a founding member and current board member of the ASRT.

Warren C. Breidenbach, M.D., is chief of the division of reconstructive and plastic surgery at the University of Arizona Medical Center. He performed the world's first long-term successful hand transplant in 1999 with a team at Louisville Jewish Hospital. He was the first president of the International Hand and Composite Tissue Allotransplantation Society and founding president of the ASRT.

Linda C. Cendales, M.D., is director of vascularized composite allotransplantation and the laboratory of microsurgery at the Emory Transplant Center. She led the team that performed the first hand transplant in Georgia in March 2011.

Eric Elster, M.D., FACS, is chair of the department of surgery at the Uniformed Services University and a transplant surgeon at Walter Reed National Military Medical Center in Bethesda, Md.

Lindsay Ess, of Richmond, Va., is a recipient of a double hand transplant performed in 2011 at the Hospital of the University of Pennsylvania.

John J. Fung, M.D., Ph.D., chairman of the Digestive Disease Institute at Cleveland Clinic, is a member of the institution's multidisciplinary team performing face transplantation, including the first near-total face transplant performed in the United States in 2008. He has served on the OPTN/UNOS Board of Directors.

Christina L. Kaufman, Ph.D., is Executive Director of the Christine M. Kleinert Institute for Hand and Microsurgery and has been involved with the Louisville VCA Program since 1999. The Louisville VCA Program is a unique collaboration between four separate institutions, the Kleinert Kutz Hand Care Center, Jewish Hospital, the Christine M. Kleinert Institute and the University of Louisville. She is a committee member of the International Society for Hand and Composite Tissue Transplantation and chairs the VCA Advisory Council of the American Society of Transplantation.

David K. Klassen, M.D., is medical director of the kidney and pancreas transplant programs at the University of Maryland Medical Center and has been a research team member of the center's Maxillofacial Composite Tissue Allograft Transplantation Program since its inception in 2008. He has served on the OPTN/UNOS Board of Directors.

W.P. Andrew Lee, M.D., is chairman of the Department of Plastic and Reconstructive Surgery at Johns Hopkins University School of Medicine. He led the surgical team that performed the first double-hand transplant in the United States in May 2009. He is a founding member of ASRT and is its president-elect.

Marlon F. Levy, M.D., FACS, is surgical director of transplantation for Baylor All Saints Medical Center in Fort Worth, Texas, and medical director for Southwest Transplant Alliance. He is a member of the OPTN/UNOS Board of Directors.

Kenneth A. Newell, M.D., Ph.D., is director of the living donor kidney transplant program at The Emory Transplant Center. He is president-elect of the American Society of Transplantation.

Bohdan Pomahac, M.D., established the plastic surgery transplantation program at Brigham & Women's Hospital in Boston and led the surgical team that performed the first full face transplant in the United States in March 2011. He is a founding member of ASRT.

Kathy Schwab, RN, CCTC, is integrity and compliance coordinator for the William J. von Liebig Transplant Center at Mayo Clinic in Rochester, Minn. She is a past president of the International Transplant Nurses Society.

Robert M. Veatch, Ph.D., is professor of medical ethics at the Kennedy Institute of Ethics, Georgetown University. He serves on the governing board of Washington Regional Transplant Community and has served multiple terms on the OPTN/UNOS Ethics Committee since 1989. Staff of the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation, also serve as ex officio, nonvoting members of the Committee.

United Network for Organ Sharing (UNOS) serves as the Organ Procurement and Transplantation Network (OPTN) by contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation. The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy.